Personality disorders classification and symptoms in cocaine and opioid addicts.

The extent to which personality disorders (PDs) and associated symptom criteria were found among 117 cocaine- and opioid-dependent men selected from 350 consecutive inpatient admissions to a Veterans Administration Drug Dependence Treatment Unit over a 30-month period was examined using structured interview methodology. Drug groups were distinguished by higher rates of antisocial and borderline symptomatology rather than by features associated with other PDs. Cocaine users showed lower rates of borderline and adult antisocial features and reported less subjective distress than opioid addicts, and different constellations of target problem features emerged for the two groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Decline in self-reported dysphoria after treatment entry in inner-city cocaine addicts.

This study examined self-reported dysphoria in 82 consecutive admissions to intensive outpatient treatment for cocaine abuse on whom data for the Beck scales for depression, anxiety, and hopelessness were available for intake and 4 subsequent weeks with no more than 1 missing data point. Mean scores on the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) decreased significantly between intake and Week 1, with no further significant changes from Weeks 1–4. Similar drops in the rate of clinically significant BDI and BAI scores also were observed. Scores on the Beck Hopelessness Scale (BHS) showed no significant changes. By Week 4, rates of clinically significant depression, anxiety, and hopelessness were similar (17%, 13%, and 16%, respectively) . These findings suggest that assessing depression and anxiety using the BDI and BAI in this population should be postponed for at least 1 week after intake and that intake levels of self-reported mood may be inappropriate baseline measures for evaluating treatment effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Levels of alcohol dependence in cocaine addicts: Some clinical implications.

Examined the severity of alcohol dependence in 268 primarily White male adult clients presenting themselves for residential treatment of cocaine addiction. Although previous research (e.g., M. Gold, 1984) has suggested that a majority of cocaine abusers also abuse alcohol, only a minority of these Ss (7%) could be classified in the substantial or severe categories of alcohol dependence. Results are discussed in light of previous findings (e.g., D. Smith; see record 1987-26330-001) which suggest that Ss in the low or moderate levels of alcohol dependence are most likely to reject abstinence-oriented treatment strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Euphorigenic doses of cocaine reduce [123I]beta-CIT SPECT measures of dopamine transporter availability in human cocaine addicts

The in vivo potency of euphorigenic doses of intravenous cocaine for displacing [123I]beta-CIT ([123I]2 beta-carbomethoxy-3 beta-(4-iodophenyl)tropane) binding to striatal dopamine transporters (DAT) was assessed in human cocaine addicts using single photon emission computed tomography (SPECT). Cocaine-dependent subjects (n = 6) were injected with [123I]beta-CIT and imaged 24 h later under equilibrium conditions. Sequential cocaine infusions (0.28 +/- 0.03 and 0.56 +/- 0.07 mg/kg) produced significant (P < 0.0005) reductions in the specific to non-specific equilibrium partition coefficient, V3" (6 +/- 6 and 17 +/- 3%), a measure proportional to DAT binding potential. Regression analysis of the logit transformed data enabled reliable determination of the Hill coefficient (0.51) and 50% displacement (ED50) dose of cocaine (2.8 mg/kg). These preliminary data suggest that cocaine produces behavioral effects in humans at measurable levels of DAT occupancy.     

Effects of kappa opioid agonists on the discriminative stimulus effects of cocaine in rhesus monkeys.

The study examined the effects of the kappa opioid agonists U50,488 and ethylketocyclazocine (EKC) on cocaine discrimination in rhesus monkeys trained to discriminate cocaine (0.4 mg/kg) from saline. Administration of U50,488 and EKC alone produced primarily saline-appropriate responding. Kappa agonist pretreatments produced variable effects on cocaine discrimination across monkeys, attenuating the discriminative stimulus effects of cocaine in some monkeys, but either having no effect on cocaine discrimination or enhancing the discriminative stimulus effects of cocaine in other monkeys. The effects of kappa agonists on cocaine discrimination were reversed by pretreatment with the opioid antagonist naloxone (1.0 mg/kg). These results indicate that kappa agonists do not consistently block the discriminative stimulus effects of cocaine in rhesus monkeys. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethanol and cocaine intake by rats selectively bred for oral opioid acceptance

Lines which accept or reject the potent opioid etonitazene, and a randomly bred control line, were assessed for the specificity of selective breeding. Drug-naive subjects from generation 8 were offered a continuous choice between water and 10% ethanol for 20 days. There was no difference between the accepting and rejecting lines in preference for one fluid, or in amount of ethanol consumed. The same rats were then given a choice between water and increasing concentrations (0.08-0.64 mg/ml) of cocaine, 7 days at each concentration. There were no differences among the lines in preference for the drug, but the rejecting line drank more of the cocaine solution than the accepting line. Finally, these rats were subjected to the regimen used in choosing rats for selective breeding, 4 days of a water-etonitazene choice. In their preference for etonitazene the order of the lines was as expected: accepting > control > rejecting. In addition, the accepting line drank more of the etonitazene solution than the other two lines. These data suggest that selection has been rather specific and not for a generalized tendency to become intoxicated.     

Boys with peer adjustment problems: Social cognitive processes.

30 4th-grade and 30 6th-grade males with positive (P) or negative (N) peer status were asked to generate alternative solutions to hypothetical problems, evaluate possible solutions, describe self-statements, and rate the likelihood of possible self-statements to investigate the hypothesis that maladjusted Ss (N peer status) would lack specific social cognitive skills. Hypothetical problems were presented in interviews that emphasized situations involving acts of aggression. Interviews were conducted in 2 parts, involving knowledge of interpersonal problem-solving strategies and attributional style assessment. Results indicate that N Ss generated fewer alternative solutions, proposed fewer assertive and mature solutions, generated more intense aggressive solutions, showed less adaptive planning, and evaluated physically aggressive responses more positively and positive responses more negatively than did P Ss. Data support the notion that boys with social adjustment problems are deficient in the cognitive problem-solving skill of generating multiple alternative solutions. Findings suggest that differences in knowledge and/or attitudes concerning normative social behavior may contribute to the more negative behavior patterns observed in socially maladjusted boys. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fluoxetine treatment for dually diagnosed methadone maintained opioid addicts: a pilot study

Twenty-two methadone maintained opioid addicts with either depression or persistent cocaine use received open label fluoxetine in addition to their methadone. Fluoxetine significantly decreased depressive symptoms from pre-treatment to endpoint in subjects with depression, while its effect on substance use was inconclusive.     

Attributions and relapse in opiate addicts.

Investigated whether attributions of opiate addicts would predict both their ability to abstain from future use and their reactions to abstinence violations. Measures of generalized beliefs about responsibility for positive and negative outcomes and specific attributions about relapse episodes were elicited from 80 addicts at the time of admission for inpatient detoxification and treatment. Addicts who at admission attributed to themselves greater responsibility for negative outcomes and who attributed relapse episodes to more personally controllable factors were subsequently (at 6-mo follow-up) more likely either to be completely abstinent or to contain the effects of temporary lapses into opiate use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patterns of opioid and cocaine co-use: A descriptive study in a Canadian sample of untreated opioid-dependent individuals.

This study examined prevalence and patterns of co-use of opioids and cocaine in regular users of illicit opioids (N=729) recruited from 5 Canadian cities. Fifty-seven percent (n=417) reported having used both opioids and cocaine in the month and week preceding the interview; of these, 73% (n=304) were able to identify a typical pattern of daily co-use. In a typical day, injectors of opioids and cocaine (n=119) and injectors of opioids who inhaled cocaine (n=111) showed stable opioid use but variable cocaine use, which peaked at 21 hr. Overall, 30% of the individuals used both drugs exclusively in a sequential fashion, 35% reported taking opioids and cocaine within the same hour, and 35% reported taking them together at the same time or mixing them. These findings indicate that different individuals display different patterns of opioids and cocaine co-use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

New scales to assess change in the Addiction Severity Index for the opioid, cocaine, and alcohol dependent.

Analyses were performed to construct and confirm the validity of new conjoint intake and 6-month follow-up scales for the Addiction Severity Index (A. T. McLellan, L. Luborsky, G. E. Woody, & C. P. O'Brien, 1980) applied to a diverse sample of substance dependence patients (N?=?1,008). A multistage scaling strategy identified 5 psychometrically integral addiction problem scales. Exploratory item and factor analyses, confirmatory oblique item clustering, and variance partitioning verified that the scales comprised relatively little common variance and that each retained a substantial amount of unique and reliable variance. Resulting scales (Psychiatric, Drug, Alcohol, Family, and Legal Problems, respectively) were highly internally consistent and structurally stable overall, at intake and follow-up and across gender, age, ethnicity, and substance abuse categories. Concurrent and predictive validity over 2 years were supported for clinical subsamples based on comorbid psychopathology and mood, HIV risk behaviors, personality indices, urine toxicology, and criminal records. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Classification and short-term course of DSM-IV cannabis, hallucinogen, cocaine, and opioid disorders in treated adolescents.

This study examined the latent class structure of Diagnostic and Statistical Manual of Mental Disorders (text rev.; DSM-IV; American Psychiatric Association, 2000) symptoms used to diagnose cannabis, hallucinogen, cocaine, and opiate disorders among 501 adolescents recruited from addictions treatment. Latent class results were compared with the DSM-IV categories of abuse and dependence, and latent transition analysis (LTA) was used to examine changes in symptom severity over a 1-year follow-up. Although 2- and 3-class solutions provided the best fit to the data (2-class: hallucinogens, cocaine, opioids; 3-class: cannabis), 3-class solutions provided more substantive results and were emphasized in analyses. There was good agreement between latent classes and DSM-IV diagnosis. LTA suggested greater likelihood of transitioning to a less severe class at 1 year for all 4 drugs; in- and outpatients differed in pattern of change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prospective relationships between drug problems and work adjustment in a community sample of adults.

The prospective relationships between drug problems and work adjustment (e.g., job instability, job satisfaction) were examined in a community sample of 470 adults. Polydrug problems (alcohol, marijuana, and cocaine problem drug use) were both predictors and consequences of work adjustment. In partial support of the impaired functioning theory, polydrug problems predicted reduced job satisfaction 4 years later. Supporting the work-related strain theory, early job instability predicted polydrug problems 4 years later. In support of the theory of general deviance, low social conformity predicted later job instability. Finally, supporting social support theory, early support for drug problems reduced polydrug problems and increased job satisfaction 4 years later. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Affective experience in psychotherapy.

118 patients and 17 therapists in individual psychotherapy completed structured-response questionnaires after each of from 5-66 consecutive sessions. Analyses focused on the frequency, structure, and correlates of reported affective experiences. Typical patient feelings included both positive and negative affective states, i.e., serious, accepted, confident, and anxious. Typical therapist feelings were predominantly positive, including interested, alert, thoughtful, and sympathetic. Dimensions were defined in the separate domains of patient and therapist feelings by means of factor analysis. Correlational analysis indicates that the affective tone of a session tended to be shared and mutually perceived by both participants. Fluctuation in patient feelings was related to variation of their reported problematic concerns; e.g., dysphoric affect accompanied concerns with isolation and with anger. (20 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Affective Deprivation in History.

Explores historical accounts of the morbid consequences of affective deprivation in infancy. Noted in particular are cases from Emperor Frederick as noted by Salimbene (1284) and King Psanimetichus of Egypt (664-610 B.C.). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Affective processes in perception.

The studies reported in this paper are classified into four general areas: (a) studies of size judgment; (b) studies of the relationships between physiological needs and perception; (c) studies on "selective sensitization" to positively valued stimuli; and (d) studies concerned with "perceptual defense." A section is also included on the various ways of defining the term perception. The author concludes that a need exists for further research, replication of existing studies, improved methodology, and a greater concern for theoretical objectives. 129-item bibliography. (PsycINFO Database Record (c) 2010 APA, all rights reserved)